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Transmission used in vehicles facilitate their operation. In devices powered by muscle power, it may allow for extending the distance covered or shortening the time it is covered. In addition, changes in the gear ratio in the drive system may increase the ability to overcome terrain obstacles such as steep slopes or loose soil, and may also assist in moving in unfavorable weather conditions, e.g. strong winds. The aim of the article is to review wheelchairs with applied mechanical transmissions and to present the concept of an innovative solution. The presented innovative solution is subject to a patent application, which is based on a variant tension transmission with a V-belt. The solution provides stepless shifting, and its implementer is presented in the article up to the functional level of the prototype. The article shows that among mechanical transmissions, toothed transmissions are most often used, while belt, chain and rope transmissions are less popular solutions. In addition, it has been noticed that an innovative direction of scientific research is the development of transmission shifting systems based on the signals of the muscle electromyography (EMG) of the upper extremities.